multiproblem family

This article summarizes four studies of process and outcome research on family outreach therapy (ATF) with multi-problem families (MPF). We examined the relationship between different "patterns of of collaboration" and outcome variables in the treatment of MPF. Furthermore, we examined the relationship between childhood adversity factors and protective factors for the development of child psychiatric symptoms, and evaluated catamnesis data (follow-up 3 years). The paper summarizes four naturalistic studies of pre and post values and follow-up data in children aged 4-18 years, participating in an integrative, structural family therapy with (X = 115 sessions in 28...

The mental-health-care treatment gap remains very large in low-resource communities, both within high-income countries and globally in low- and middle-income countries. Existing approaches for disseminating psychological interventions within health systems are not working well enough, and hard-to-reach, high-risk populations are often going unreached. Alternative implementation models are needed to expand access and to address the burden of mental-health disorders and risk factors at the family and community levels...

Immigrants and second-generation immigrants from Ethiopia in Israel are assumed to be more vulnerable to problematic risk behaviours than host culture population. The aim of this study was to assess risk and protective factors associated with multiproblem behaviours such as committing driving violations, alcohol use, drugs use and violence among Ethiopian young adult immigrants and second-generation immigrants in Israel. This is a cross-sectional study, based on a self-reported anonymous structured questionnaire distributed to 383 Ethiopian emerging adults (mean age 25...

Multidimensional family therapy (MDFT) is an established treatment program for youth displaying multiproblem behavior. We examined whether MDFT decreased criminal offending among cannabis abusing adolescents, as compared with individual psychotherapy (IP). In a Western European randomized controlled trial comparing MDFT with IP, a sample of 169 adolescents with a cannabis disorder completed self-reports on criminal offending. Half indicated they had committed one or more criminal offenses in the 90 days before the baseline assessment...

This study investigated baseline client characteristics that predicted long-term treatment outcomes among adolescents referred from school and community sources and enrolled in usual care for conduct and substance use problems. Predictor effects for multiple demographic (age, sex, race/ethnicity), clinical (baseline symptom severity, comorbidity, family discord), and developmental psychopathology (behavioral dysregulation, depression, peer delinquency) characteristics were examined. Participants were 205 adolescents (52 % male; mean age 15...

The purpose of this study was threefold, namely (1) to differentiate between multiproblem families and control families on characteristics and processes within the family based on a theoretical framework, (2) to identify multiproblem families by establishing cut-off scores on various questionnaires, and (3) to categorize multiproblem families into subtypes by cluster analyses. Various questionnaires were administered to multiproblem families (n = 85) and control families (n = 150). Results showed that what we propose to refer to as multiproblem families present a broad range of problems on seven domains: (1) child factors, (2) parental factors, (3) childrearing problems (inadequate or inconsistent parenting), (4) family functioning problems, (5) contextual problems, (6) social network problems, and (7) mental health care problems...

Abstract This qualitative, feminist study is focused on lesbians' experiences growing up in multiproblem families, surviving aftereffects of trauma, and struggling with alcohol problems. A multi-racial sample of 20 lesbians narrated life stories in a series of three in-depth interviews. The research report opens with one woman's narrative about surviving childhood sexual abuse and continues with explication of how differences and similarities within and between accounts pivot on the issues of sexual orientation, gender, and race...

The Continuity Case Conference provides a model for teaching family medicine residents the value, importance, and impact of developing long-term doctor-patient relationships. A resident's presentation of challenging patient cases and the ensuing group interaction with resident peers, faculty, and medical staff are designed to offer residents alternate perspectives on complex, multiproblem cases while validating the often emotional process of patient care. This learning model is designed to demonstrate how a physician, in the context of the cumulative progression of contacts with a patient, can better manage myriad health issues, chronic and acute, and improve patient outcomes...

The primary goal of this study was to compare several variable-centered and person-centered methods for modeling multiple risk factors during infancy to predict the quality of caregiving environments at six months of age. Nine risk factors related to family demographics and maternal psychosocial risk, assessed when children were two months old, were explored in the understudied population of children born in low-income, non-urban communities in Pennsylvania and North Carolina (N = 1047). These risk factors were (1) single (unpartnered) parent status, (2) marital status, (3) mother's age at first child birth, (4) maternal education, (5) maternal reading ability, (6) poverty status, (7) residential crowding, (8) prenatal smoking exposure, and (9) maternal depression...

The author has joined in many community case conferences for several years. In some instances it has been possible to keep records and thereby conduct long term follow-up study. The results of such follow-up indicate that this type of conference can be useful in providing assistance to multiproblem families which would be impossible without the cooperation of many nonmedical and medical professionals. In addition to this, there are many benefits to be gained by increased familiarity with various health workers and their roles...

Some children, whom we have labeled poly-victims, experience very high levels of victimizations of different types. This article finds support for a conceptual model suggesting that there may be four distinct pathways to becoming such a poly-victim: (a) residing in a dangerous community, (b) living in a dangerous family, (c) having a chaotic, multiproblem family environment, or (d) having emotional problems that increase risk behavior, engender antagonism, and compromise the capacity to protect oneself. It uses three waves of the Developmental Victimization Survey, a nationally representative sample of children aged 2-17 years...

Conduct problems are strong positive predictors of substance use and problem substance use among teens, whereas predictive associations of depressed mood with these outcomes are mixed. Conduct problems and depressed mood often co-occur, and such co-occurrence may heighten risk for negative outcomes. Thus, this study examined the interaction of conduct problems and depressed mood at age 11 in relation to substance use and problem use at age 18, and possible mediation through peer substance use at age 16. Analyses of multirater longitudinal data collected from 429 rural youths (222 girls) and their families were conducted using a methodology for testing latent variable interactions...

OBJECTIVE: To assess reasons for discrepancies between primary care consultation measured from patient self-report and that based on medical records. METHODS: Retrospective comparison of recalled consultation in previous 12 months among 2,414 subjects aged 50+ who reported knee pain in a population survey vs. primary care medical records. Record review included (1) all knee morbidity codes and (2) knee problems mentioned in consultation text. It was then extended to: (3) more than 12 months before survey, and (4) consultations for leg or widespread problems (e...

OBJECTIVE: Although previous studies of shorter duration have identified numerous risks and protective factors that powerfully influence outcomes in young adulthood and midlife, this long-term prospective study examines the effect of these prognostic factors on age at retirement and satisfaction with retirement. METHOD: In this prospective study, a cohort of socially disadvantaged men (N=151) were followed from adolescence until a mean age of 75 years (SD=2). Periodic interviews, biennial administration of questionnaires, and physical examinations every 5 years were conducted to determine biopsychosocial risk variables, age at retirement, and satisfaction with retirement...

OBJECTIVES: To implement and evaluate the effectiveness of scenario-based learning as a method for teaching systems-based practice to pediatric residents. METHODS: Twelve pediatric residents at the University of Florida/Jacksonville participated in an active learning scenario experience during their 1-month community pediatrics block rotation from January 2003 to April 2004. A scenario, developed in partnership with community-based organizations, required the residents to assume the role of a parent faced with multiproblem life situations requiring skills in prioritizing problems and identifying and accessing community resources to address them...

Nurse-client relationships have been considered the foundation of successful home-visiting programs for vulnerable families. Even though nurse-client relationships are important when working with multiproblem families, relationship theory has not been used to guide interventions in home visiting. Identification of a fitting theory could provide direction for tailoring interventions to families at a "dose" individualized to meet their needs. This article reports a small study that tested the applicability of Peplau's theory of interpersonal relations in nursing (Peplau, 1952/1991) in the context of home visiting...

OBJECTIVE: To describe the basis on which our knowledge of frequent attendance in general practice rests and to propose recommendations for further research on frequent attenders (FAs). DESIGN: The literature review (finished February 2004) encompassed peer-reviewed articles in English describing contacts with general practice in terms of frequency. Searches were performed in the Medline, CINAHL, EMBASE, PsycINFO, Social Sciences Expanded Index and ISI Citation databases with additional searches in reference lists and the 'related articles' function in the ISI Citation database and Medline...

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Although the practice of family therapy in dialectical behavior therapy (DBT) with multiproblem suicidal adolescents is common and generally indicated, a particular model has yet to be delineated with this age group. The purpose of this article is to propose a coherent clinical synthesis of the more individually oriented DBT strategies with a broader family-systems orientation that maintains the integrity of both theoretical approaches while addressing the treatment needs of adolescents and their families. First, the authors briefly review the literature...

This study asked clients from multiproblem families to describe a successful helping relationship. The replies were analyzed using narrative research techniques and results are presented in conceptual categories with illustrative quotations from the interviews. The article offers conclusions about client preferences in the areas of working relationship, work styles, and worker characteristics. The results revealed two general domains of the client-worker relationship: factors that provided a sense of equality in the relationship, for example, love, friendship, and a nonjudgmental stance; and the notion that the helping relationship should parallel more normative contacts and include components such as flexibility, chemistry, luck, and going the extra distance...